Key result
Cellular heterogeneity and signaling in pulmonary vein sleeves contribute to ectopic activity and AF maintenance.
Why the study?
Ectopic activity in pulmonary vein cardiac muscle sleeves can induce and maintain atrial fibrillation, but their differences from left atrial muscle remain a central issue.
This review highlights the physiological mechanisms, including signaling pathways and cellular heterogeneity, that differentiate pulmonary vein cardiac muscle sleeves from left atrial tissue and contribute to atrial fibrillation.
Ectopic activity in the pulmonary vein cardiac muscle sleeves can both induce and maintain human atrial fibrillation. A central issue in any study of the pulmonary veins is their difference from the left atrial cardiac muscle. Here, we attempt to summarize the physiological phenomena underlying the occurrence of ectopic electrical activity in animal pulmonary veins. We emphasize that the activation of multiple signaling pathways influencing not only myocyte electrophysiology but also the means of excitation-contraction coupling may be required for the initiation of triggered or automatic activity. We also gather information regarding not only the large-scale structure of cardiac muscle sleeves but also recent studies suggesting that cellular heterogeneity may contribute to the generation of arrythmogenic phenomena and to the distinction between pulmonary vein and left atrial heart muscle.
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Bredeloux et al. (2021) conducted a review in Atrial fibrillation. Cellular heterogeneity and the activation of multiple signaling pathways in pulmonary vein cardiac muscle sleeves contribute to ectopic electrical activity and the maintenance of atrial fibrillation.
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